{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:41:11Z","timestamp":1772466071873,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Staged proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for medically refractory pediatric ulcerative colitis (UC). This study aimed to compare the surgical outcomes of 2-stage and 3-stage IPAA in children of similar disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We queried the NSQIP-Pediatric database (2016-2023) to identify patients under 18\u2009years with UC undergoing IPAA. Patients undergoing IPAA with concurrent colectomy were classified as having a 2-stage procedure, while those undergoing IPAA alone, following a prior colectomy, were classified as having a 3-stage procedure. The primary outcome was a composite of major complications within 30\u2009days, including mortality, organ\/space infection, progressive renal insufficiency, systemic sepsis, and intra-abdominal reoperation. The treatment groups were matched using 1:1 propensity score matching to adjust for baseline differences in disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 479 patients met the inclusion criteria (330 underwent 3-stage and 149 underwent 2-stage procedures). The proportion of patients undergoing each approach remained stable over the study period (P\u2009=\u2009.693). At the time of pouch creation, the 2-stage group had significantly higher rates of steroid use (22.8% vs 14.5%), leukocytosis (21.9% vs 7.1%), and hypoalbuminemia (mean 4.0 vs 4.2\u2009g\/dL). After matching, 137 patient pairs were included. There was no significant difference in major complication rates between groups (OR, 1.38; 95% CI, 0.63-3.09).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated that surgical outcomes following pouch creation were similar in a matched cohort of children undergoing 2- or 3-stage IPAA, supporting the use of a 2-stage approach in certain patients with limited disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf241","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T12:07:19Z","timestamp":1758715639000},"page":"461-467","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Pouch Creation in 2-Stage Versus 3-Stage Procedures for Pediatric Ulcerative Colitis: A Propensity Score Matched Comparative Analysis"],"prefix":"10.1093","volume":"32","author":[{"given":"Humza","family":"Thobani","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-3161","authenticated-orcid":false,"given":"Anam N","family":"Ehsan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoosha","family":"Moturu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene M L","family":"Nepomuceno","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maliha","family":"Taufiq","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Aga Khan University , Karachi,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nida","family":"Zahid","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Aga Khan University , Karachi,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy F","family":"Tirrell","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl G","family":"Sylvester","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saleem","family":"Islam","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Aga Khan University , Karachi,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5846-8771","authenticated-orcid":false,"given":"Faraz A","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children\u2019s Hospital, Stanford University , Palo Alto, 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